Response to treatment for visceral leishmaniasis in patients coinfected by Leishmania/HIV

Authors

DOI:

https://doi.org/10.18378/rebes.v13i3.9827

Abstract

Visceral Leishmaniasis (VL) in patients immunosuppressed by the human immunodeficiency virus (HIV) is usually a severe opportunistic disease. The management of VL in people living with HIV (PLHIV) is challenging, since these patients have a poor response to antileishmania treatment, with a risk of chronic evolution and a high rate of VL recurrence. This study aims to describe the response to anti-leishmania treatment in patients co-infected with Leishmania/HIV, highlighting the factors that hinder the proper management of VL and the treatment alternatives capable of improving the response of these patients to anti-leishmania therapy. This is a bibliographical research conducted in the MEDLINE, LILACS, EMBASE, SCOPUS and SCIENCE DIRECT databases, including articles published between 2017 and 2023, with themes relevant to the object of study, with 16 studies being selected to be discussed. Studies point out that the main factors associated with poor response to VL treatment in PLHIV are the difficulty in achieving the appropriate concentration of antileishmania drugs in the body of these patients, lack of secondary prophylaxis, lack of effective antiretroviral therapy (ART), previous relapse VL, low immunity, co-infection with tuberculosis and poor nutritional status. The administration of antileishmanial drugs in a combined regimen instead of monotherapy, together with the early initiation of ART and the institution of secondary prophylaxis can improve the outcome of VL in patients co-infected with Leishmania/HIV. However, effective treatment for VL in these patients is still a challenge, and it is necessary to find more effective ways to improve therapeutic response.

Key words: Visceral leishmaniasis. HIV infection. Antileishmania treatment. Combination therapy.

Downloads

Download data is not yet available.

Author Biographies

Marianny da Silva Barreto, Centro Universitário Christus (UNICHRISTUS)

Discente do Curso de Medicina do Centro Universitário Christus (UNICHRISTUS)

Ana Leticia Lira Paulino, Centro Universitário Christus (UNICHRISTUS)

Discente do Curso de Medicina do Centro Universitário Christus (UNICHRISTUS)

Maria Clara Sousa Evangelista Vieira, Centro Universitário Christus (UNICHRISTUS)

Discente do Curso de Medicina do Centro Universitário Christus (UNICHRISTUS)

TATIANA PASCHOALETTE RODRIGUES BACHUR, Centro Universitário Christus (UNICHRISTUS)

Docente do curso de Medicina da Universidade Estadual do Ceará - UECE.

References

ABONGOMERA, Charles et al. The initial effectiveness of liposomal amphotericin B (AmBisome) and miltefosine combination for treatment of visceral leishmaniasis in HIV co-infected patients in Ethiopia: a retrospective cohort study. Plos Neglected Tropical Diseases, [S.L.], v. 12, n. 5, p. 1-19, 25 maio 2018. Public Library of Science (PLoS). DOI: http://dx.doi.org/10.1371/journal.pntd.0006527

ADERIE, Endashaw M. et al. Does timing of antiretroviral treatment influence treatment outcomes of visceral leishmaniasis in Northwest Ethiopia? Transactions Of The Royal Society Of Tropical Medicine And Hygiene, [S.L.], v. 111, n. 3, p. 107-116, 1 mar. 2017. Oxford University Press (OUP). DOI: http://dx.doi.org/10.1093/trstmh/trx023

ALVAR, J. et al. The relationship between leishmaniasis and AIDS: the second 10 years Clin Microbiol Ver, [S.L.], v. 21, n. 2, p. 334-359, abr. 2008. DOI: http://dx.doi.org/10.1128/CMR.00061-07

ARAÚJO, Camila Freire et al. New world Leishmania spp. infection in people living with HIV: concerns about relapses and secondary prophylaxis. Acta Tropica, [S.L.], v. 224, p. 106146, dez. 2021. Elsevier BV. DOI: http://dx.doi.org/10.1016/j.actatropica.2021.106146

BOURGEOIS, N. et al. Long-term monitoring of visceral leishmaniasis in patients with AIDS Relapse risk factors, value of polymerase chain reaction and potential impact on secondary prophylaxis. J Acquir Immune Defic Syndr. v.48, p:13-19, 2008. DOI: http://dx.doi.org/110.1097/QAI.0b013e318166af5d.

BURZA, Sakib et al. AmBisome Monotherapy and Combination AmBisome–Miltefosine Therapy for the Treatment of Visceral Leishmaniasis in Patients Coinfected With Human Immunodeficiency Virus in India: a randomized open-label, parallel-arm, phase 3 trial. Clinical Infectious Diseases, [S.L.], v. 75, n. 8, p. 1423-1432, 11 fev. 2022. Oxford University Press (OUP). DOI: http://dx.doi.org/10.1093/cid/ciac127

CAMARA, Lara; QUEIRÓS, João; RIBEIRO, Rita; TEÓFILO, Eugénio. Meglumine antimoniate combination treatment for relapsing Kala-azar after treatment and secondary prophylaxis failure with liposomal amphotericin B in two HIV-coinfected patients. BMJ Case Reports, [S.L.], v. 12, n. 12, p. 1-4, dez. 2019. BMJ. DOI: http://dx.doi.org/10.1136/bcr-2019-231929

CAMPINO, L.; MAIA, C. Epidemiologia das leishmanioses em Portugal, Acta Med Port. v.23, p:859-864, 2010.

CHECHI, Flavia et al. Case Report: intravenous pentamidine rescue treatment for active chronic visceral leishmaniasis in an hiv-1 infected patient. The American Journal Of Tropical Medicine And Hygiene, [S.L.], v. 106, n. 2, p. 639-642, 2 fev. 2022. American Society of Tropical Medicine and Hygiene. DOI: http://dx.doi.org/10.4269/ajtmh.21-0600

CIPRIANO, Patrícia; MIRANDA, Ana Cláudia; ANTUNES, Isabel; MANSINHO, Kamal. Leishmaniose Visceral em Doentes com Infeção VIH: o desafio da recaída e falência terapêutica. Acta Médica Portuguesa, [S.L.], v. 30, n. 6, p. 443-448, 30 jun. 2017. Ordem dos Médicos. DOI: http://dx.doi.org/10.20344/amp.8291

DIRO, Ermias et al. A randomized trial of AmBisome monotherapy and AmBisome and miltefosine combination to treat visceral leishmaniasis in HIV co-infected patients in Ethiopia. Plos Neglected Tropical Diseases, [S.L.], v. 13, n. 1, p. 1-19, 17 jan. 2019. Public Library of Science (PLoS). DOI: http://dx.doi.org/10.1371/journal.pntd.0006988

DIRO, Ermias et al. Long term outcomes and prognostics of visceral leishmaniasis in HIV infected patients with use of pentamidine as secondary prophylaxis based on CD4 level: a prospective cohort study in ethiopia. Plos Neglected Tropical Diseases, [S.L.], v. 13, n. 2, p. 1-17, 21 fev. 2019. Public Library of Science (PLoS). DOI: http://dx.doi.org/10.1371/journal.pntd.0007132

DIRO, Ermias et al. Long-term Clinical Outcomes in Visceral Leishmaniasis/Human Immunodeficiency Virus–Coinfected Patients During and After Pentamidine Secondary Prophylaxis in Ethiopia: a single-arm clinical trial. Clinical Infectious Diseases, [S.L.], v. 66, n. 3, p. 444-451, 13 set. 2017. Oxford University Press (OUP). DOI: http://dx.doi.org/10.1093/cid/cix807

FARIAS, F. T. G. et al. Perfil epidemiológico de pacientes diagnosticados com leishmaniose visceral humana no Brasil. Revista Ciência & Desenvolvimento, v.12, n. 3, p.485 - 501, 2019. http://srv02.fainor.com.br/revista/index.php/memorias/article/view/965/486

GOSWAMI, Rama P. et al. Protective Efficacy of Secondary Prophylaxis Against Visceral Leishmaniasis in Human Immunodeficiency Virus Coinfected Patients Over the Past 10 Years in Eastern India. The American Journal Of Tropical Medicine And Hygiene, [S.L.], v. 96, n. 2, p. 285-291, 22 nov. 2016. American Society of Tropical Medicine and Hygiene. DOI: http://dx.doi.org/10.4269/ajtmh.16-0432

GUNDEL, H.; HERMANN, F. Review: HIV infection and tropical parasitic diseases–deleterious interactions in both directions? Trop Med Int Health, v.7, p:479–488, 2013. DOI: https://doi.org/10.1046/j.1365-3156.2002.00893.x

GUPTA, G.; OGHUMU, S.; SATOSKAR, A.R Mechanisms of immune evasion in leishmaniasis. Adv Appl Microbiol., v.82, p. 155–184, 2013. DOI: 10.1016/B978-0-12-407679-2.00005-3

KIP, Anke e et al. Low antileishmanial drug exposure in HIV-positive visceral leishmaniasis patients on antiretrovirals: an ethiopian cohort study. Journal Of Antimicrobial Chemotherapy, [S.L.], v. 76, n. 5, p. 1258-1268, 2 mar. 2021. Oxford University Press (OUP). DOI: http://dx.doi.org/10.1093/jac/dkab013

LIMA, I. M. et al. Desenvolvimento das vacinas contra leishmaniose. Revista Coopex, v. 10, p. 1 - 11, 2019. DOI: http://dx.doi.org/10.1093/jac/dkh084

LÓPEZ-VÉLEZ, R. et al. Amphotericin B lipid complex versus no treatment in the secondary prophylaxis of visceral leishmaniasis in HIV-patients. J Antimicrob Chemother. v.53, p:. 540-543, 2004. DOI: http://dx.doi.org/10.1093/jac/dkh084

MASTROIANNI, Antonio et al. Two cases of relapsed HIV-associated visceral leishmaniasis successfully treated with combination therapy. Aids Research and Therapy, [S.L.], v. 15, n. 1, p. 1-4, dez. 2018. Springer Science and Business Media LLC. DOI: http://dx.doi.org/10.1186/s12981-018-0215-x.

MENEZES, J. et al. in development of new treatment for leishmaniasis. Biomed Res Int. v. 2015, p. 815023, 2015. DOI: http://dx.doi.org/10.1155/2015/815023

MOLINA, I. et al. Efficacy of liposomal amphotericin B for secondary prophylaxis of visceral leishmaniasis in HIV-infected patients. J. Antimicrob Chemother. v.60, n. 4, p. 837-842, 2007. DOI: http://dx.doi.org/10.1093/jac/dkm294

MONGE-MAILLO, B. et al. Leishmaniasis and HIV coinfection in the Mediterranean region. PLoS Negl Trop Dis. v.8, n. 8, p. e3021, 2014. DOI: http://dx.doi.org/10.1371/journal.pntd.0003021

OLIVER, M. et al. The pathogenesis of Leishmania/HIV co-infection: cellular and immuno- logical mechanisms. Ann Trop Med Parasitol. v. 1, p. 79-98, 2003. DOI: http://dx.doi.org/10.1179/000349803225002561

PINTADO, V. et al. Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non HIV-infected patients. A comparative study. Medicine. v.80, p. 54-73, 2001. DOI: http://dx.doi.org/10.1097/00005792-200101000-00006

REINALDO, Luis G. C. et al. Splenectomy in patients with visceral leishmaniasis resistant to conventional therapy and secondary prophylaxis: a retrospective cohort. The American Journal Of Tropical Medicine And Hygiene, [S.L.], v. 107, n. 2, p. 342-348, 17 ago. 2022. American Society of Tropical Medicine and Hygiene. DOI: http://dx.doi.org/10.4269/ajtmh.21-0376

RUSSO, R. et al. Visceral leishmaniasis in those infected with HIV: clinical aspects and other opportunistic infections. Ann Trop Med Parasitol. v.97, p. 99-105, 2003. DOI: https://doi.org/10.1179/000349803225002570

SILVA-FREITAS, Maria Luciana et al. Impaired thymic output can be related to the low immune reconstitution and t cell repertoire disturbances in relapsing visceral leishmaniasis associated HIV/AIDS patients. Frontiers in Immunology, [S.L.], v. 11, n. 953, p. 1-14, 20 maio 2020. Frontiers Media SA. DOI: http://dx.doi.org/10.3389/fimmu.2020.00953

SIMÃO, José Cláudio; VICTÓRIA, Cassiano; FORTALEZA, Carlos Magno Castelo Branco. Predictors of relapse of visceral leishmaniasis in inner São Paulo State, Brazil. International Journal of Infectious Diseases, [S.L.], v. 95, p. 44-49, jun. 2020. Elsevier BV. DOI: http://dx.doi.org/10.1016/j.ijid.2020.02.028

SINGH, O. P.; SUNDAR, S. Immunotherapy and targeted therapies in treatment of visceral leishmaniasis: current status and future prospects. Front Immunol. v.5, p. 296, 2014. DOI: http://dx.doi.org/10.3389/fimmu.2014.00296

Downloads

Published

2023-08-03

How to Cite

Barreto, M. da S., Paulino, A. L. L., Vieira, M. C. S. E., & BACHUR, T. P. R. (2023). Response to treatment for visceral leishmaniasis in patients coinfected by Leishmania/HIV. Revista Brasileira De Educação E Saúde, 13(3), 201–209. https://doi.org/10.18378/rebes.v13i3.9827

Issue

Vol. 13 No. 3 (2023)

Section

ARTICLES

License

Copyright (c) 2023 Marianny da Silva Barreto, Ana Leticia Lira Paulino, Maria Clara Sousa Evangelista Vieira, TATIANA PASCHOALETTE RODRIGUES BACHUR

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Termo de cess

Most read articles by the same author(s)

<< < 1 2 3